Suicide in San Francisco.

Abstract

As I had always had a long-felt desire to visit San Francisco, I applied for an elective there in clinical suicidology offered by the University of California's department of psychiatry. Once accepted, I prepared to fly out, not knowing quite what to expect. Psychiatry? In California? people asked, in voices tinged with scorn, conjuring images of pandering to the egos of rich neurotic divorcees. Then, eyes narrowed ever so slightly in suspicion, they queried further: And why San Francisco? alluding to the city's reputation as a centre for generations of outcasts, from the Beat Poets of the '50s, through the hippies of the '60s, to its current invasion by America's more exuberant homosexuals. I arrived with an open mind, leaving time to explore and find a home before starting work. The medical school stands between the wooded hilltop which forms the city's high point and the broad green gash of the Golden Gate Park. It is reached by way of the Haight, where dishevelled remnants of hippy Mecca days lead dogs past boutique windows and tramp-owned nighttime doorways. In the park nearby hordes of lunchtime joggers model sportswear on the grass, while serious runners pant eucalyptus air downhill to the roaring surf of Ocean Beach. I found a room in the Sunset, a quiet cocoon surrounding the medical centre and home to many of its workers. Even here, amid the vegetarian restaurants and alternative bookshops, the smell of street fear at night is strong: by the General Hospital, far on the other side of town in the poor Spanish heart of the Mission District, it is overpowering, with the hospital a haven from the clamour and violence around it. It was here that I worked, often with the victims of that violence and sometimes with its perpetrators.